Parameter Goals/Recommendations Diet – Follow Australian dietary guidelines with attention to quantity and type of food.– If CVD risk is a concern, recommend an individual dietary review. Body Mass Index (BMI) – Therapeutic goal: 5-10% weight loss for people who are overweight or obese with type 2 diabetes.– For BMI…

Action: Facilitates glucose uptake, lowers blood glucose levels. Efficacy: Most potent glucose-lowering agent.HbA1c: reduce 1.5 – 3.5% w monotherapy Side Effects: Hypoglycemia, weight gain. Studies: UKPDS and ORIGIN trials confirm cardiovascular safety and reduced microvascular complications. Types of Short-Acting Insulin Type Insulin Name Brand Name Onset Duration Rapid-Acting Insulin Insulin…

Diabetes insipidus (DI) Diabetes insipidus CAUSES OF CENTRAL DIABETES INSIPIDUS ASSESSMENT DIAGNOSIS

https://www.racgp.org.au/getattachment/e5311638-b32d-4a11-88b3-9a35ee268d83/Hypoglycaemia-in-nondiabetic-patients-an-evidence.aspx Traditional Classification: Criticisms of Traditional Classification: Alternative Classification Based on Clinical Characteristics: from AustRAliAn FAmily PhysiciAn Vol. 39, no. 6, june 2010 = Hypoglycaemia in nondiabetic patients – an evidence based approach: Common Causes of Hypoglycaemia: Specific Hypoglycaemia Types: Idiopathic Postprandial Hypoglycaemia: Idiopathic Postprandial Syndrome (Pseudohypoglycaemia): Biochemical Differentiation of…

OVERVIEW PATHOPHYSIOLOGY Here is a more detailed comparison of Hyperosmolar Hyperglycemic Nonketotic State (HONK) and Diabetic Ketoacidosis (DKA), focusing on etiology, pathology, signs, symptoms, management, and follow-up based on Australian guidelines: Aspect HONK (Hyperosmolar Hyperglycemic Nonketotic State) DKA (Diabetic Ketoacidosis) Etiology – Common in type 2 diabetes, elderly patients.– Precipitating…

Diabetic Ketoacidosis (DKA) potentially life-threatening complication of diabetes mellitus resulting from the consequences of insulin deficiency Precipitants for DKA Common triggers of DKA include: Ketosis-Prone Type 2 Diabetes (KPD) AFP: Ketoacidosis in a patient with type 2 diabetes – Flatbush diabetes Volume 44, Issue 1, January-February 2015 Evaluation for the…

Macrovascular Complications of Diabetes 1. Coronary Artery Disease (CAD) 2. Peripheral Artery Disease (PAD) 3. Cerebrovascular Disease HYPERTENSION DYSLIPIDAEMIA Microvascular Complications of Diabetes 1. Nephropathy Definitions in diabetic renal disease Normal Microalbuminuria (incipient nephropathy) Clinical ‘overt’ nephropathy Units 24 hour urinary albumin <30 30-300 >300 mg/day Urine albumin excretion rate <20…

Preparation for Sick Days: When to Initiate the Sick Day Plan: Blood Glucose Monitoring: If You’re Unable to Access Support: Managing Low Blood Glucose (Hypoglycaemia): Important: Do not drive if blood glucose levels are below 5 mmol/L. Managing High Blood Glucose (Hyperglycaemia): Blood Ketone Monitoring: If Taking Diabetes Tablets or…

The criteria for the diagnosis of diabetes are now: https://www.diabetessociety.com.au/guideline/hba1c-for-diagnosis-of-diabetes-mellitus-may-2023 In an asymptomatic patient the test should be repeated for confirmation of the result and diagnosis. An abnormal result on 2 different diagnostic tests is also acceptable Treatment Algorithm Overview https://www.diabetessociety.com.au/wp-content/uploads/2023/03/ADS_POSITION-STATEMENT_v2.4.pdf All patients should receive education on lifestyle measures, including:…

Initial Management Plan 1. Patient Education and Individualized Targets 2. Multidisciplinary Team (MDT) Approach 3. Non-Pharmacological Management 4. Lifestyle and Cardiovascular Risk Reduction 5. Ongoing Reviews and Monitoring Quarterly Review:  Yearly Review:  The Blood Glucose Profile in Type 2 Diabetes In type 2 diabetes, the blood glucose profile consists of…

Diagnosis Assessing diabetes risk Patients should be assessed for diabetes risk  Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK)  AUSDRISK score developing type 2 diabetes within five years 5 or less: Low risk 6–11: Intermediate risk 12 or more: High risk The following people are also considered at high risk,…

Type 1 diabetes Type 2 DM: can occur in children + adolescents if overweight but usually older adults, often family hx. Most people are asymptomatic. Latent Autoimmune Diabetes of Adults (LADA):  Monogenic diabetes Gestational diabetes mellitus: Medication induced diabetes: commonly prednisolone + olanzapine that may require hypoglycaemics, once med withdrawn…